The sun is beginning to set in Fada N'gourma, Burkina Faso, a land-locked country in West Africa roughly the size of the state of Nevada. The Marie Stopes International mobile outreach team is finishing a long day of providing services to women from this town and its surrounding villages for counselling and contraception. As the last few women gather their belongings and adjust babies on their backs, the team waits.
In the twilight along the dusty road, a new group becomes visible. Eight or nine young women, mostly teenagers, approach the health centre accompanied by community health workers. Regular clinic hours are not an option for these young women; they are unmarried, and so are unwilling or unable to seek contraception openly in front of their relatives and neighbours. MSI Burkina Faso works with local community health workers to spread the word of upcoming visits to adolescents and offers them later access to services after most other women are gone.
Young women and girls face many of the same barriers to contraception and other sexual and reproductive health services as their older, married counterparts, not just in Burkina Faso, but all around the world. Adolescents also must battle a host of additional obstacles related to their age, marriage and social status. Traditional delivery models and values must evolve to serve these young people. It can be done. Already in West Africa, considerably more than a third of Marie Stopes International's clients are younger than 25.
But getting services to young people is just the first step. Adolescents need choice in their reproductive health care. Choice begins with high-quality counselling and continues with access to all contraceptive methods, including long-acting reversible contraception to complement those more frequently available such as condoms, oral contraceptive pills, and injectables; complemented by follow up over the entirety of the woman's reproductive years.
Flexible and adaptable models must be developed to ensure broad access and choice. Health service teams must adapt their operations to meet the unique needs of adolescents and other underserved groups. For Marie Stopes International, this can mean teams of clinical providers covering difficult terrain in 4x4 vehicles, nurses on motorbikes serving densely populated urban slums, or working to ensure that private sector providers who already reach adolescents meet our stringent global quality standards. Marie Stopes International takes a whole-of-market approach, working to strengthen the public system, whilst partnering with private providers, trained and accredited by us into quality-assured social franchise networks.
As the global health community comes together in the coming months to establish the new Global Financing Facility (GFF) for reproductive, maternal, newborn, child and adolescent health (RMNCAH), we must all commit to the principles of voluntarism, quality, access and trust. Success will hinge on whether we conquer this challenge. Success will require partnership and collaboration.
This partnership will be most important at the national level. The GFF can augment and encourage the work of national governments, many of whom are demonstrating innovation and accrediting trusted partners into national health insurance schemes. Countries are successfully contracting out specialised reproductive health services in places like Kenya, Tanzania or The Philippines to partners like Marie Stopes International. Key partnerships, including with United Nations Population Fund (UNFPA) to mobilise essential contraceptive commodities, will help strengthen the foundations of national health systems and build momentum for country-led financing, including universal health insurance, which in turn sustains developmental impact.
As we in the global health community move forward with the GFF, it is critically important to ensure we meet the needs of what will be the largest group of young people in our history, who are right now entering into their reproductive years. Serving young women now with life-saving sexual and reproductive health services can mitigate the devastating effects of poverty, and will help to build a truly sustainable development agenda in the post 2015 era and beyond.